Individual
DR. EDWARD CHARLES COLLINS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3367 DOUGLAS RD, SOUTH BEND, IN 46635-1779
(574) 272-8823
(574) 277-1837
Mailing address
270 E DAY RD, SUITE 260, MISHAWAKA, IN 46545-3444
(574) 272-8823
(574) 277-1837
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12012076A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201225610
—
IN
Enumeration date
04/06/2010
Last updated
12/21/2021
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